部分中文Xalkori处方资料（仅供参考）
FDA批准Xalkori (crizotinib)治疗晚期肺癌
2011年8月26日，美国食品和药物管理局（FDA）批准Xalkori (crizotinib)治疗某些有局部晚期或转移性非小细胞肺癌(NSCLC)的病人，其肿瘤表达异常间变型淋巴瘤激酶（ALK）基因。
Xalkori和配套的诊断性试验一同获准，有助于确定病人是否存在异常ALK基因，这个基因检测称为Vysis ALK分离FISH探针检测盒。Xalkori是FDA今年批准的此类靶向治疗的第二个。
ALK基因异常导致癌症发生与生长。NSCLC病人中约有1%~7%的病人有ALK基因异常。这种类型的肺癌病人通常是非吸烟者。Xalkori通过阻断激酶而发挥作用，包括由异常ALK基因产生的蛋白。Xalkori是单药治疗，1片，每日2次。
Xalkori的安全性和有效性是经2项多中心、单组研究确定的，研究共纳入255例晚期ALK阳性的NSCLC病人。在纳入研究前，病人的肺癌组织标本被采集，并作ALK基因异常的检测。该研究的设计是观测客观疗效反应率，以及肿瘤完全或部分萎缩病人的百分比。纳入研究的病人大多既往接受过化疗。
在一项研究中，客观有效率为50%，中位疗效维持时间为42周。在另一项研究中，客观有效率为61%，中位疗效维持时间为48周。
FDA批准Vysis ALK分离FISH 探针检测盒是基于上述研究之一的数据。Xalkori的审查被列入FDA优先审查项目。
“肿瘤学研究的趋势仍是靶向治疗”，美国FDA体外诊断设备评价和安全办公室主任Alberto Gutierrez说。“这种检测是一个例子，说明了配套诊断的重要作用，它可以使有严重和致命疾病的患者及时得到最安全和最有效的治疗。”
接受Xalkori治疗病人最常报告的副作用包括视力障碍、恶心、腹泻、呕吐、水肿和便秘。视力障碍包括视力损害、闪光、视力模糊、悬浮物、复视、对光敏感和视野缺损。用Xalkori还与肺部炎症相关，可能会危及生命。患有治疗相关肺炎的患者应永久停止Xalkori治疗。本药不应用于妊娠妇女。
处方药:处方药
包装规格: 250毫克/胶囊 60胶囊/瓶
生产厂家中文参考译名:辉瑞
生产厂家英文名:PFIZER
FDA NEWS RELEASE
For Immediate Release: Aug. 26, 2011
Media Inquiries: Erica Jefferson, 301-796-4988
Consumer Inquiries: 888-INFO-FDA
FDA approves Xalkori with companion diagnostic for a type of late-stage lung cancer
Second targeted therapy approved with a test this year
The U.S. Food and Drug Administration today approved Xalkori (crizotinib) to treat certain patients with late-stage (locally advanced or metastatic), non-small cell lung cancers (NSCLC) who express the abnormal anaplastic lymphoma kinase (ALK) gene.
Xalkori is being approved with a companion diagnostic test that will help determine if a patient has the abnormal ALK gene, a first-of-a-kind genetic test called the Vysis ALK Break Apart FISH Probe Kit. It is the second such targeted therapy approved by the FDA this year.
This ALK gene abnormality causes cancer development and growth. About 1 percent to 7 percent of those with NSCLC have the ALK gene abnormality. Patients with this form of lung cancer are typically non-smokers. Xalkori works by blocking certain proteins called kinases, including the protein produced by the abnormal ALK gene. Xalkori is a pill taken twice a day as a single-agent treatment.
“The approval of Xalkori with a specific test allows the selection of patients who are more likely to respond to the drug” said Richard Pazdur, M.D., director of the Office of Oncology Drug Products in the FDA’s Center for Drug eva luation and Research. “Targeted therapies such as Xalkori are important options for treating patients with this disease and may ultimately result in fewer side effects.”
Xalkori’s safety and effectiveness were established in two multi-center, single-arm studies enrolling a total of 255 patients with late-stage ALK-positive NSCLC. A sample of a patient’s lung cancer tissue was collected and tested for the ALK gene abnormality prior to study enrollment. The studies were designed to measure objective response rate, the percentage of patients who experienced complete or partial cancer shrinkage. Most patients in the studies had received prior chemotherapy.
In one study, the objective response rate was 50 percent with a median response duration of 42 weeks. In another, the objective response rate was 61 percent with a median response duration of 48 weeks.
The FDA based its approval of the Vysis ALK Break Apart FISH Probe Kit on data from one of the studies.
Xalkori was reviewed under the FDA’s priority review program, which provides for an expedited six-month review of drugs that may offer major advances in treatment or that provide a treatment when no adequate therapy exists.
Xalkori is being approved under the FDA’s accelerated approval program, which allows the agency to approve a drug to treat a serious disease based on clinical data showing that the drug has an effect on an endpoint that is reasonably likely to predict a clinical benefit to patients. The program is designed to provide patients with earlier access to promising new drugs, followed by further studies to confirm the drug’s clinical benefit.
Xalkori and the companion Vysis ALK Break Apart FISH Probe Kit were approved ahead of the drug’s Sept. 30, 2011, FDA review goal date and the companion diagnostics’ Sept. 28, 2011, review goal date.
“The trend in oncology research continues towards targeted therapies,” said Alberto Gutierrez, Ph.D., director of the Office of In Vitro Diagnostic Device eva luation and Safety in the FDA’s Center for Devices and Radiological Health. “This test is an example of the important role companion diagnostics play in determining that the safest and most effective treatments are promptly delivered to patients living with serious and life-threatening diseases.”
The most common side effects reported in patients receiving Xalkori included vision disorders, nausea, diarrhea, vomiting, swelling (edema), and constipation. Vision disorders included visual impairment, flashes of light, blurred vision, floaters, double vision, sensitivity to light, and visual field defects. Xalkori use has also been associated with inflammation of the lung tissue (pneumonitis), which can be life-threatening. Patients with treatment-related pneumonitis should permanently stop treatment with Xalkori. The drug should not be used in pregnant women.
In July 2011, FDA issued a draft guidance industry on the agency’s policy for reviewing a companion diagnostic and the corresponding drug therapy. The guidance is currently available for public comment.
Xalkori is marketed by New York City-based Pfizer. The Vysis ALK Break Apart FISH Probe Kit is marketed by Abbott Molecular Inc. of Des Plaines, Ill.
